Behavioral Sciences

Attention deficit hyperactivity disorder (ADHD) presents significant challenges in all age groups, affecting various aspects of daily functioning and quality of life. Objective: This study aims to explore the rate and associated factors of unemployment among ADHD in adults. A retrospective cohort study was conducted, including 179 adults diagnosed with ADHD seeking consultation at a comprehensive ADHD clinic at a tertiary hospital in urban Oman. Sociodemographic characteristics, clinical presentations, and factors associated with employment status were collected. 41% of the participants were actively seeking employment. Among the correlates of unemployment is obesity (OR 5.64, p = 0.011, 95% CI 1.49–21.43). Other variables, including education level and marital status, also influenced employment rates, with bachelor’s degree holders showing higher chances of unemployment (OR 5.35, p = 0.009, 95% CI 1.52–18.88). Marital status was closely associated with unemployment, with 39.5% of married individuals unemployed (p = 0.022). Furthermore, anxiety disorders were closely associated with unemployment (p = 0.026). Nearly one-third of the cohort had a comorbid substance use disorder (30%), and 6% reported suicidal attempts. This study highlights the significantly high prevalence of job seeking among adults with ADHD. Obesity, education level, marital status, and anxiety disorders were strongly associated with job search.

The current study explores the social experiences of adolescent and transition-age youths with intellectual disabilities (IDs) and the support mechanisms available to these groups in Saudi Arabia. This study adopts a qualitative methodology with a semi-structured interview constituting the data collection method involving 13 parents with children aged between 11 and 19 years, a critical adolescent period and transition to early adulthood. The results suggest that family, caregivers, community, friendships, and healthcare providers play important roles that impact the quality of life for these groups. The main challenges identified include health-related issues, employment challenges, educational barriers, insufficient services, inadequate community participation, and limited social relationships, with special emphasis on obstacles linked to transition during the 18 to 19-year period when youths must navigate transfers from pediatric to adult services and changes associated with legal rights. This study highlights several reasons it is important to increase awareness and education, while also continuing to improve support systems aimed at dealing with both transition challenges and adolescent needs. The results further illustrate that although support from family provides the foundation for care, systemic changes are needed to promote social inclusion and reduce stigma during critical development periods. The current study contributes to the limited research related to IDs in the context of the Middle East, with special reference to Saudi Arabia. Finally, the discussion highlights several insights that are culturally specific for the development of policy and provision of services associated with the transition from adolescence to early adulthood.

Caregiver-mediated approaches in early intervention can provide impactful support for families of young children with social communication needs. Project ImPACT (PI), a caregiver-mediated naturalistic developmental behavioral intervention, was tested for effectiveness in public early intervention (EI) programs in a randomized waitlist-control community trial across California. Participants included EI service providers (n = 47) and caregiver–child dyads (n = 125; ages 14–32 months). Families received services-as-usual (SAU) or PI following provider training in PI. Multilevel models were used to examine provider coaching, caregiver–child interactions, caregiver PI strategy use, parenting stress, self-efficacy in parenting, and child social communication outcomes across approximately four months of services. Provider use of evidence-based coaching significantly improved after PI training. Caregivers who received PI showed greater gains in some domains of parent–child interaction; PI fidelity scores, stress, and self-efficacy did not differ by condition. Child communication outcomes improved over time in both groups, but differences between conditions were not detected during the study time period. Training community EI providers in PI improved coaching quality and enhanced caregiver–child interaction, demonstrating feasible, scalable use of PI in community settings. Differential child-level effects were not detected, underscoring the need for larger samples and longitudinal follow-up.